The “Evidence-based Post-Covid-19-Assessment" (EPOCA) was developed for the assessment and description of individuals potentially affected by a post-Covid-19 condition. The aim of the assessment was to facilitate the combination and interpretation of collected findings as well as standardization of the diagnostic work-up in terms of a documentation aid.
The development of EPOCA was supported by the Swiss Insurance Medicine (SIM). It is intended to be used throughout the longitudinal course of Long COVID in all relevant areas of health care, e.g., by primary care providers, in special consultations, in rehabilitation services, etc. The screening tool should help to document Long COVID symptoms, therapeutic interventions, and course development uniformly in a low-threshold manner. The outcomes of the screening provide a basis for disease management, reintegration measures at work and in education.
The EPOCA questionnaire
The EPOCA questionnaire consists of various parts for external and self-assessment. This means some of the questions are directly answered by the patient and address their subjective experience of the symptoms, while others will be externally assessed by a health care professional. Moreover, the questionnaire takes into account socio-demographic variables, risk factors, and clinical symptoms as well as aspects related to work, insurance and quality of life. By including all these aspects, the assessment provides a structuring and decision-making aid for the overall assessment of the individual case constellation. In detail EPOCA includes clinically established and standardized questionnaires as well as additional questions which are especially relevant to Long COVID patients. In total, the questionnaire consists of approximately 180 questions.
The SIM recommends insurances to recognize EPOCA as a tool for the diagnosis of Long COVID and the evaluation of a patient’s level of disease burden.
In a possible insurance medical assessment, the recording sheet from EPOCA serves as a delimitation aid in the recording of symptoms and risk factors. Thus, the tool can help in decisions on consultation of further specialist disciplines and with decision-making in the classification of the symptoms.
Moreover, the assessment can be used in insurance medicine for the evaluation of a person affected by Long COVID-like symptoms with regards to disability pensions. Due to its comprehensive structure, the questionnaire allows a thorough assessment of the patient. However, completing the full questionnaire can take up to two hours, which can be very energy draining, especially for patients affected by Long COVID.
Overall, EPOCA is a useful tool to assess the symptoms of patients suffering from Long COVID and, if used more regularly, could help to improve care for these patients by providing a better foundation for informed decision-making.